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Spinal fusion
Definition Spinal fusion is surgery to correct problems in the spine bones (vertebrae). The surgery stabilizes the back by fusing certain bones in the spine together. Fusing means two bones are permanently placed together ("fused") so that movement between them can no longer occur. Alternative Names Vertebral interbody fusion; Posterior spinal fusion; Arthrodesis; Anterior spinal fusion Description Spinal fusion surgery uses bone grafts, with or without screws, plates, cages, or other devices. The bone grafts are placed around the problem area of the spine during surgery. As the body heals itself, the graft helps join the bones together. The most common spinal area treated is the lower (lumbar) spine. However, it can also be done on the upper (cervical) spine. The procedure is performed while you are under general anesthesia (unconscious and pain-free). The surgeon makes a cut over the area of the spine that will be treated. If you are having a problem in the lower spine corrected, the repair is done through a surgical cut made directly over the spine. This is called the posterior lumbar approach. If you are having a problem in the upper spine corrected, the repair is usually done through a surgical cut in the front or side of the neck (anterior cervical spine). If you are having a problem in the middle spine corrected, the repair is sometimes done through a surgical cut in the chest and abdomen (anterior thoracic spine). Depending on the reason for surgery, the procedure may involve a combination of surgical cuts. Indications Spinal fusion may be recommended for abnormal curvatures, such as those seen with scoliosis or kyphosis. It may also be used to treat or correct the following conditions: - Injury or fractures to the bones in the spine
- Herniated disk
- Weak or unstable spine caused by infections or tumors
Risks Risks for any anesthesia include the following: - Reactions to medications
- Problems breathing
Risks for any surgery include the following: Additional risks include the following: - Urinary difficulties (including urinary retention)
- Temporarily decreased or absent intestinal function (paralytic ileus)
Expectations after surgery This surgery is usually very successful. Convalescence You will need to stay in the hospital for several days after surgery. The repaired spine should be kept in proper position to maintain alignment. If the surgery involved a surgical cut in the chest, a chest tube may be used to drain fluid build-up. The tube is usually removed after 24-72 hours. You will be taught how to move properly, how to reposition, and how to sit, stand, and walk. You'll be told to use a "log-rolling" technique when getting out of bed. This means that you move your entire body at once, and not twist the spine. There is usually considerable pain for the first few days after surgery. You will be given pain medication, perhaps by patient-controlled analgesia (PCA). You may also have a urinary catheter (tube) to collect your urine. Because of the risk of temporary paralysis after spinal surgery, you may not be able to eat for 2-3 days and will be fed through an IV. When you leave the hospital, you may need to wear a back brace or cast. Review date: 9/21/2006 Reviewed By: Jeffrey Kauffman, MD, Sacramento Knee and Sports Medicine, Sacramento, CA. Review provided by VeriMed Healthcare Network.
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